How are drugs developed to target specific areas (pain/allergies/disease). How do you translate scientific body knowledge into a drug that targets that area. And how do scientists determine cross reactions to other drugs or conditions. Do they have to test every combo?
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Mosey on over to r/researchchemicals or r/steroids, r/PEDs. You’ll find a mixture of ELI5/layman level explanations and also some higher level explanations.
I’ll describe the drug development process. It takes a long time to find a new drug that works but here are the steps from beginning to end.
1. Pre-discovery: scientists are studying a specific disease at the molecular level to find out how the disease occurs. They do experiments looking at DNA and proteins to understand what causes something to happen. For example, in some cancers there is a gene called PD-1 which makes the cancer cell hard to kill by our immune system. Now PD-1 becomes a drug target.
2. Discovery: scientists are discovering molecules that inhibits PD-1. They screen thousands of different molecules that will interact with PD-1 to find candidate molecules. Once discovered, these molecules are optimized for better targeting in order to be used in animals.
3. Pre-clinical: candidate molecules are now extensively tested in different animal models for safety, toxicity, and efficacy. In addition, these molecules will be tested for drug interactions. Our body metabolizes drugs using different enzymes called CYP so each molecule will be tested to see how it is metabolized. If it is metabolized similarly to another drug then they will be interactions which means the effect and/or side effects will be enhanced or reduced and it must be labeled on the drug package insert. All drugs are metabolized through chemical reactions so knowing how is important to ensure safety of the drug so yes all combinations of metabolism are tested. Most of the metabolism occurs in the liver though.
4. Human drug testing: Once they’ve established the max tolerable dose in animals and evidence that the molecules are working to treat the disease, they will be dosed in humans. This is done in different stages, typically phase 1 through phase 3 where 1 and 2 are mainly to find the best dose for the drug while testing safety and efficacy and 3 is a longer trial using the best doses while testing safety and efficacy. Once all good, all the data will be submitted to the FDA and they will decide on approval or not.
Some antimicrobial drugs are used on a certain part of bacteria that human cells don’t contain (peptidoglycan cell wall) so a drug will have no effect on humans but will against the infection
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